HomeMy WebLinkAbout4226 APPLEGATE CT - MISCELLANEOUS - 9/13/2001F_. t Collirrs residential energy cods 1
Mechanical systems disclosure forr
Job address:
General contractor:
Mechanical contractor:
space heating system
/96
Location
BASEMENT
Fuel
GAS
T e
F A
Manufacturer
Model #
6
Input capacity AFUE or
kBtuh or kW HSPF
Space cooling system
Location
Fuel
T e
Manufacturer
Model #
Inputcapacity
or kW SEER
GAS
F/A
LPhnd
Water heating system
Location Input capacity Energy Storage
Fuel TvDe Manufacturer Model # kBtuh or kW Factor volume
Certification
I/We certify that the above -listed equipment was installed in the building at the above locations in conformance with the
current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code, and that it was installed in
accordance with manufacturer's instructions. INVe certify that any ductwork has been installed in conformance with
the current requirements of the City of Fort Collins Residential Energy Code and Mechanical Code.
Certified by: ROBERT R MTT,T,F.R Phone: (970) 223-8873
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Business firmTjpRS1 COIIJRADO AIR, INC.Date:
Address:1823 E HARMONY RD Signature:
Instructions
This disclosure form is to be signed by the mechanical contractor or representative of the general contractor.
Please type or print, except for the signature.
If there are multiple systems serving any function, make multiple entries to describe them.
One copy of this form shall be provided to the Building and Zoning Department at final inspection.
One -copy of -this -form shall be provided tathe homebuyer.
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